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| | Malpractice Suits Increase In Japan As Medical Mistakes Are Uncovered
TOKYO - Like the cardiologist who has a heart attack or the radiologist who discovers a tumor, Hideaki Nakajima, an orthopedic surgeon, felt a pain in his hip one day.
That marked the beginning of Nakajima's transformation - from doctor to patient and, finally, to outspoken critic of Japan's medical system.
For years, Nakajima had been a typical doctor, examining a parade of patients each day, his practice at a university hospital a textbook example of what the Japanese call ``three-minute medicine,'' which refers to the average length of time a patient spends with a doctor.
Nakajima had no time to explain his procedures or his diagnoses to patients, but that didn't matter. In Japan, patients usually aren't even told what's wrong with them. The medical system is paternalistic, with doctors as the all-knowing fathers, leaving the patient with few rights - no access to medical records, little chance for second opinions. Drugs are often dispensed in little white boxes so patients don't know what they're taking. They're not even likely to be told if they have a terminal illness.
``The idea is that patients don't need to know, and that it's not good to give them all the facts. It will just confuse them and won't make sense,'' said Rihito Kimura, a leading bioethicist at Waseda University in Tokyo.
That is beginning to change. Recently, small patients advocacy groups have sprung up and are questioning the system. They want a patient's bill of rights, similar to one drawn up by U.S. hospitals in the early 1970s that gave patients a right to ``informed consent'' before they are subjected to medical procedures or treatments, a privilege that still doesn't exist in Japan.
Some Japanese are even doing something normally frowned upon in this nonlitigious society. They are suing.
When Nakajima became a patient, his world view turned upside down.
``When I was working, everything seemed fine,'' he said. ``Only now can I see that doctors don't really take care of patients.''
His metamorphosis began when a fellow orthopedist operated on Nakajima's hip to remove loose cartilage. Afterward, Nakajima thought something didn't feel quite right. He questioned the doctor. Everything was fine, he was assured.
Then Nakajima broke his hip, was hospitalized three times and had to take a year's leave of absence from work. He began to suspect the break was caused by something that had gone wrong in the surgery. He increasingly pressed his surgeon and the hospital where they both worked for information, but got nothing except growing hostility.
He finally discovered, he said, that the doctor had made a blunder during surgery by pulling his hip joint out of place. But it wasn't the mistake that outraged Nakajima. It was the cover-up by his fellow doctors and their unwillingness to explain his own condition to him. No one, all the way up to the head of the department where Nakajima worked, would admit that anything had gone wrong.
``Even when I confronted the doctor, he still just tried to hide it. He wouldn't tell me the truth,'' Nakajima said.
The Japanese public is growing worried about medical mistakes. In recent months, newspapers have carried almost daily accounts of hospitals and doctors being forced to come forward and admit blunders: Lung surgery performed on a man with a heart ailment; a woman implanted with someone else's fertilized egg; a nurse who inadvertently put disinfectant in an intravenous drip.
Some argue that such mistakes are more likely in Japan because of the veil of secrecy that protects hospitals from regular public scrutiny. But many analysts think the apparent rash of deadly blunders is not so abnormal; it's just that hospitals are being forced to admit them by increasingly vigilant patients, the media and other doctors.
``Ten years ago, it would have been possible to hide these things, because colleagues would autom
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``Ten years ago, it would have been possible to hide these things, because colleagues would automatically agree to secrecy, whereas now they don't,'' said Ian Neary, a British academic who has extensively studied the Japanese medical system.
Indeed, Japan is not the only country struggling with ways to make the medical system more publicly accountable. A landmark study last December by the National Institutes of Health estimated that doctors' mistakes kill 44,000 to 98,000 Americans every year, more than from auto accidents, breast cancer or AIDS.
No similar figures are available for medical errors in Japan, but one thing is certain: Japanese patients are far less likely to sue over these mistakes.
Compared with the estimated half-million medical malpractice lawsuits pending in the United States, the numbers in Japan are minuscule, but they are growing. Today, there about 3,000 cases pending, double a decade ago. Analysts estimate there is also an increasing number of out-of-court settlements, but figures are hard to come by, in part because the doctors' powerful lobbying group, the Japan Medical Association, refuses to publicly release statistics.
โดย: เจ้าบ้าน [25 ส.ค. 51 14:34> ( IP A:210.86.181.20 X: )
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Lawsuits and patient anger are increasingly directed, not at the medical blunders themselves, but at the lack of information. Kana Okaniwa's father was given an experimental medicine by his doctor and died eight weeks later. She contends the medicine killed him and that he was not informed of the potential side effects by the doctor.
``The doctor never even told him what the medicine was for,'' Okaniwa said.
Last November, she filed a lawsuit, which is much more difficult in Japan than in the United States. There are only a few dozen lawyers who pursue malpractice suits, and just five in the entire country who handle them full time.
Finding a doctor to testify on the plaintiff's behalf is equally difficult. Okinawa wound up flying to Philadelphia to find an American doctor who would offer medical testimony for her case.
``The medical profession is much more closed than in the U.S.,'' said Kimura, who also has taught at Georgetown University for two decades.
Until the late 1960s, the U.S. medical establishment operated in a similar fashion. Doctors routinely kept information and records from patients, sometimes subjecting them to experimental treatments without their knowledge. Many also were reluctant to tell a patient of a terminal illness.
โดย: เจ้าบ้าน [25 ส.ค. 51 14:35> ( IP A:210.86.181.20 X: )
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Though less common than before, it still remains the norm in Japan for doctors not to tell patients they are dying or, in particular, have cancer. Medical observers say cancer patients are given the treatments they need, like chemotherapy or radiation, but are told that their tumors are benign.
``Doctors don't tell patients about their diseases when they judge that the patient might get depressed, or if it wouldn't help matters. They do it to protect the patient,'' said Akira Koizumi, vice president of the doctors' lobby.
Withholding such information, however, also makes it impossible for Japanese cancer patients to take an active role in their treatment, as American cancer patients commonly do, researching their disease and asking questions about the best options.
In Japan, the image of the paternalistic, beneficent doctor derives from strong Confucian values imported from China. In Japan, the doctor, who is always addressed by the honorific ``sensei,'' which means teacher, has long been viewed as a wise and intellectual person.
Also, in Japan, Kimura said, the lack of communication between doctor and patient is in keeping with the cultural dislike for direct speech. It's considered much more respectful to talk about something uncomfortable, such as an illness, either indirectly, or not at all.
โดย: เจ้าบ้าน [25 ส.ค. 51 14:36> ( IP A:210.86.181.20 X: )
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There are small signs that the system is starting to change. The Ministry of Health and Welfare is adding to the national medical exam a section on bioethics and patient rights. That, in turn, will force medical schools to start teaching the subjects.
Still, the doctors' lobbying group, which has close ties to the government, is trying to preserve the status quo. Last year, the group managed to squash plans to give patients access to their medical records. Japanese patients have little reason to complain, the group has long argued, because they are fortunate enough, thanks to Japan's national health-care system, to have access to cheap health care.
In general, in fact, the Japanese are among the healthiest people in the world, with a life expectancy of 74.5 years, 4 1/4 years longer than Americans.
Orthopedic surgeon Nakajima has found out just how powerful the medical establishment can be - and how unwilling it is to tolerate dissent within its own ranks. His persistent questioning of his treatment was unwelcome, he said. When he tried to return to work at his hospital after his yearlong medical leave, he was forced to resign.
Now he's filed a malpractice suit, and has been ostracized by the medical community, leaving him little hope of finding a job at any hospital. Instead, he spends his time advising other patients on their legal rights.
``I stand as a warning to other doctors,'' Nakajima said, ``to say if you stand out or stand up, you will be treated like this.''
โดย: เจ้าบ้าน [25 ส.ค. 51 14:37> ( IP A:210.86.181.20 X: )
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a typical doctor, examining a parade of patients each day, his practice at a university hospital a textbook example of what the Japanese call ``three-minute medicine,'' which refers to the average length of time a patient spends with a doctor.
แปลได้ความว่า หมอญี่ปุ่นก็ตรวจสามนาทีเป็นมาตรฐานเหมือนแถวๆนี้
The idea is that patients don't need to know, and that it's not good to give them all the facts. It will just confuse them and won't make sense,'' said Rihito Kimura, a leading bioethicist at Waseda University in Tokyo.
หมอคิดว่าไม่จำเป็นต้องบอกอะไรคนไข้ เดี๋ยวจะสับสน (คนไข้แมร่งโง่ ถ้ามันฉลาดก็ต้องเป็นหมอสิวะ) นี่ก็ลอกกันมาเลย 555
When Nakajima became a patient, his world view turned upside down.
``When I was working, everything seemed fine,'' he said. ``Only now can I see that doctors don't really take care of patients.''
ตอนยังเป็นหมออยู่ รู้สึกว่าทุกอย่างมันดีแล้ว แต่พอตกเป็นเหยื่อความมดเท็จทางการแพทย์เองถึงได้มองเห็น ว่าหมอชุ่ยมีมากขนาดไหน หมอคนไหนว่าไม่จริงขอให้มานเจอกับตัวเอง
Last November, she filed a lawsuit, which is much more difficult in Japan than in the United States. There are only a few dozen lawyers who pursue malpractice suits, and just five in the entire country who handle them full time.
Finding a doctor to testify on the plaintiff's behalf is equally difficult. Okinawa wound up flying to Philadelphia to find an American doctor who would offer medical testimony for her case.
จะหาทนายคดีฟ้องหมอก็หายาก ยิ่งหมอที่จะช่วยเป็นพยานแพทย์ต้องบินไปหาที่อเมริกานั่นทีเดียว
In Japan, the image of the paternalistic, beneficent doctor derives from strong Confucian values imported from China. In Japan, the doctor, who is always addressed by the honorific ``sensei,'' which means teacher, has long been viewed as a wise and intellectual person.
คนญี่ปุ่นมักจะเรียกหมอว่า "อาจารย์"(เหมือนๆกันเลยเนอะ ถ้าเรียกหมอเฉยๆมันไม่รื่นหู)
Still, the doctors' lobbying group, which has close ties to the government, is trying to preserve the status quo. Last year, the group managed to squash plans to give patients access to their medical records. Japanese patients have little reason to complain, the group has long argued, because they are fortunate enough, thanks to Japan's national health-care system, to have access to cheap health care.
กลุ่มหมอนักล็อบบี้ก็มีสายสัมพันธ์กับนักการเมืองอำนาจอุปถัมภ์ จะไม่ให้เปิดเผยข้อมูลแก่คนไข้ง่ายๆ มีเหมือนกันอีก โอ้วสาดดด
โดย: เจ้าบ้าน [25 ส.ค. 51 15:01> ( IP A:210.86.181.20 X: )
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estimated that doctors' mistakes kill 44,000 to 98,000 Americans every year, more than from auto accidents, breast cancer or AIDS.
No similar figures are available for medical errors in Japan, but one thing is certain: Japanese patients are far less likely to sue over these mistakes.
Compared with the estimated half-million medical malpractice lawsuits pending in the United States, the numbers in Japan are minuscule, but they are growing. Today, there about 3,000 cases pending, double a decade ago. Analysts estimate there is also an increasing number of out-of-court settlements, but figures are hard to come by, in part because the doctors' powerful lobbying group , the Japan Medical Association, refuses to publicly release statistics.
ค่อยๆแปลต่อได้ความว่า ... แพศยา ยุ่นก็ทำตัวเป็นซ่องโจร เหมือนประเทศสารขัณฑ์ ปกปิดความผิดกันเอาไว้ไม่ยอมเปิดเผย แถมใช้อิทธิพลสารพัด
แปลได้แค่นี้ก็หลับตานึกภาพได้ ... สันดอนโจร จะเป็นโจรยากูซ่า หรือโจรก๊กไหนๆ พฤติกรรมซ่องโจรก็เหมือนๆกัน | | โดย: เดี๋ยวลืม [29 ส.ค. 53 19:54] ( IP A:58.8.11.55 X: ) |  |       | | |
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จริงเหรอนี่ รู้ถึงไหน อายถึงนั่น | | โดย: น้องน้อยหน่า หน้าบาง [29 ส.ค. 53 20:30] ( IP A:115.67.224.235 X: ) | |
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